1. Integration and Better Care Fund 2017-19
ADASS PSI Network
19 May 2017

2. Content Context and overview National conditions Monitoring
Known/unknown
Where the opportunities may lie

3. Context and overview
Initial Better Care Fund in £3.4bn minimum but £5.3bn pooled in 2015/16, £5.8bn in 2016/17
Integration and Better Care Fund £5.128bn in 2017/18 and £5.617bn in 2018/19 (two years)
Includes £2bn additional funding announced in spring budget (three years)
iBCF is the only mandatory policy to facilitate integration
‘graduation’ from iBCF for small number of advanced areas
Adult Social Care planned savings for 2016/17 were £941m (8% of net ASC savings)

4. National conditions and purpose
Conditions that need to be met are:
Plans to be jointly agreed (CCGs and Local Authorities and Health and Well-Being Boards)
NHS contribution to adult social care is maintained in line with inflation
Agreement to invest in NHS commissioned out of hospital services, which may include 7 day services and adult social care
Managing transfers of care
Definitions associated with conditions contain reference to implementing the High Impact Change Model
Support Sustainability and Transformation Programme and Accident and Emergency Delivery Boards i.e. not another set of brand new stuff
Clear that part of this extra funding is intended to enable local authorities to quickly provide stability and extra capacity in local care systems

5. The Improved Better Care Fund Grant Determination 2017/18

6. Monitoring
iBCF grant directly to local authorities via a Section 31 grant from the DCLG. (grant already being paid)
May be used only for the purpose of meeting adult social care needs, reducing pressures on the NHS, including supporting more people to be discharged from hospital when they are ready, and ensuring the local social care market is supported.
A recipient local authority must ‘provide quarterly reports as required by the Secretary of State’
Local authorities are therefore able to spend the grant, including to commission care, subject to the conditions set out in the grant determination, as soon as plans have been locally agreed.
National Performance Metrics: Local areas to agree and report metrics in the following four areas:
Delayed Transfers of Care
Non-elective admissions (General and Acute)
Admissions to residential and care homes; and
Effectiveness of reablement

7. Known/unknown
Other than policy framework published in March 2017 and the formal determination issued to local authorities planning tools and timescale are in draft
Once final versions issued timescale for completion likely to be quick
Major unknown is what happens after iBCF – two year programme, three year funding. What about year four
Although welcome extra funding it does not put back what has been taken out

8. Where the opportunities may lie
Integrating around eye health has been an often talked of ambition
Linking what you do to the conditions and the metrics
Local authorities seem to be planning a combination of investment in long term ‘prevention’, market capacity and supporting councils to manage persistent pressures
Investments than can evidence overall reduced cost/better outcomes within the three year window